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Kaiser Daily Global Health Policy Report

In The News

Nearly 21M People Worldwide On ARV Therapy, UNAIDS Report Says, Outlines Steps Needed To End Epidemic

Reuters: New ARV drugs, early diagnosis key to beating AIDS epidemic: UNAIDS
“Developing new antiretroviral (ARV) drugs and using technology for early diagnosis are among steps needed to sustain momentum in fighting HIV/AIDS and ending the disease as a public health threat by 2030, UNAIDS said in a report on Monday. The U.N. AIDS agency said that by June this year around 21 million people were receiving life-prolonging ARV treatment, with rapid progress seen over the past five years…” (Roelf, 11/20).

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WHO Global Ministerial Conference Commits To Ending TB In Moscow Declaration

CIDRAP News: Global health ministers commit to end TB
“Capping off the end of the first-ever World Health Organization (WHO) health minister meeting on ending tuberculosis (TB) under way in Moscow [last] week, representatives from 114 countries [Friday] agreed on an urgent set of actions called the Moscow Declaration to End TB…” (Schnirring, 11/17).

U.N. News Centre: U.N.-led ministerial conference in Moscow agrees universal commitment to end tuberculosis
“…The newly minted Moscow Declaration to End TB is a promise to increase multisectoral action as well as track progress, and build accountability. It will also inform the first U.N. General Assembly High-Level Meeting on TB in 2018, which will seek further commitments from heads of state…” (11/17).

Xinhua News: New global effort launched to end tuberculosis by 2030: WHO
“…The delegates promised to … strengthen health systems and improve access to people regarding TB prevention and care, so that no one is left behind. They also agreed to mobilize sufficient and sustainable financing through increased domestic and international investments to close gaps in implementation and research. Resources are expected to advance research and development of new tools to diagnose, treat, and prevent TB, and to build accountability through a framework to track and review progress on ending TB…” (Xuequan, 11/18).

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More Nations Implement Plans To Address Antimicrobial Resistance, U.N. Survey Shows

CIDRAP News: Survey highlights progress on national AMR action plans
“A new global survey has found that more than 90 percent of the world’s population now live in a country that has developed or is working on a national action plan to combat antimicrobial resistance (AMR). The survey, conducted in November 2016 by the World Health Organization (WHO), the United Nations Food and Agriculture Organization (FAO), and the World Organisation for Animal Health (OIE), also found that most countries that have implemented or are developing an AMR action plan are taking a One Health approach to the issue, addressing antibiotic use in both humans and animals…” (Dall, 11/17).

U.N. News Centre: With U.N. support, more countries confronting threat of drug-resistant ‘superbugs’
“…Since the survey was completed last year (2016), more countries have unveiled plans to tackle AMR. Yet despite the progress, the global push to address this problem — which is taking epic proportions — is still in its early stages…” (11/17).

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World Toilet Day Highlights Global Lack Of Access To Sanitation, Hygiene Facilities

Deutsche Welle: World Toilet Day: A private matter of public health
“…Sunday [was] World Toilet Day. In its 2015 Sustainable Development Goals, the World Health Organization set a target of providing all people with clean drinking water and functioning sanitary systems by the year 2030. In the paper, the WHO emphasizes the importance of providing for the needs of the poor — especially women and girls, for whom toilets are about more than hygiene and health: They are also about safety and education…” (Wagner, 11/19).

NPR: PHOTOS: Peep At The Toilets Of 7 Families Around The World
“…To get a better idea of the range of toilets around the world, take a look at Dollar Street. It’s a project that catalogs everyday objects — like toys, soap, stoves and of course, toilets — to provide a snapshot of life at different income levels across the globe. The project was created by Anna Rosling Ronnlund, the co-founder of Gapminder, a group that uses infographics to explain the world…” (Jochem, 11/19).

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Puerto Rico's Health System Continues To Struggle 2 Months After Hurricane Maria, Especially In Rural Areas

Wall Street Journal: Two Months After Maria, Puerto Rico’s Health System Struggles to Meet Needs
“…Two months after Hurricane Maria tore across the island, Puerto Rico’s health care system is still struggling. Storm damage and power outages remain problems especially in rural areas where access is still difficult, say medical volunteers and relief workers who have worked on the U.S. territory in recent weeks. … Most Puerto Rican hospitals have regained power, though the island’s grid remains shaky and generators still keep one in five hospitals running, according to recent Federal Emergency Management Agency data. Seventeen hospitals lacked phone service, FEMA said…” (Evans/Campo-Flores, 11/19).

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Yemen Faces Famine If Port Blockades Continue To Restrict Humanitarian, Medical Aid Deliveries, U.N., MSF Warn

Associated Press: MSF says it can’t deliver live-saving aid to Yemen capital
“International aid group Doctors Without Borders says it has not been able to deliver live-saving medical and humanitarian assistance to the people in dire need in the Yemeni capital because of a blockade by a Saudi-led coalition fighting Yemen’s Shiite rebels…” (11/18).

New Yorker: The Catastrophe of Saudi Arabia’s Trump-Backed Intervention in Yemen
“…Reporting in Yemen with a local BBC film crew this summer, I entered the country by making a fifteen-hour drive through remote areas to avoid coalition and Houthi forces. It was my sixth trip to the country in three years, and it revealed a rapidly deteriorating humanitarian situation. Food shortages that plagued remote villages had spread to large cities in the country of twenty-eight million. Along with the cholera outbreak, the number of meningitis cases was surging…” (Al-Maghafi, 11/17).

U.N. News Centre: Famine may be unfolding ‘right now’ in Yemen, warns U.N. relief wing
“The United Nations relief wing on Friday warned of famine-like conditions unfolding in Yemen, as a blockade on aid and other essential goods by a Saudi-led coalition fighting Houthi rebels there enters its 12th day. Jens Laerke, spokesperson for the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), sounded the alarm during the regular bi-weekly news briefing in Geneva…” (11/17).

Washington Post: Yemen is on the brink of a horrible famine. Here’s how things got so bad.
“…According to the United Nations, Yemen is in urgent need of medicines, vaccines, and food. The supplies ‘are essential to staving off disease and starvation,’ the organization said. … They warn that 3.2 million people are at risk of famine, and 150,000 malnourished children could die in the next month. … A least 17 million other people, including 11 million children, are in desperate need of humanitarian supplies…” (Erickson, 11/19).

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Madagascar Successfully Stems Plague Outbreak

NPR: How Madagascar Took Control Of Its Plague Outbreak
“…According to World Health Organization estimates, in just over three months, more than 2,000 have become became ill, 171 of whom have died. By comparison, Madagascar saw about 300 cases in 2015 and 2016 each. But this week, WHO announced that new cases and hospitalizations are declining…” (Bichell, 11/19).

Vox: Good news: Madagascar hasn’t seen a new plague case in 3 weeks
“…A potential global health disaster appears to be averted, at least for now, thanks to basic public health measures — and a few lessons learned from the infamous 2013-16 Ebola epidemic. … As soon as it became clear Madagascar’s plague season was unusually forceful this year, the WHO delivered 1.2 million doses of free antibiotics to treat the infected and prevent disease in people who might have been exposed to the bacteria…” (Belluz, 11/17).

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U.N. Human Rights Official Calls On El Salvador To Stop Enforcing Law Requiring Jail Terms For Women Who Have Undergone Abortion

Reuters: U.N. calls on El Salvador to stop jailing women for abortion
“El Salvador should apply a moratorium on laws that punish women with harsh jail terms for having an abortion while it reviews cases of those already incarcerated in the socially conservative Central American country, a top U.N. official said Friday…” (Rentaria/Garcia, 11/17).

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More News In Global Health

Associated Press: Top China diplomat talks refugee crisis with Myanmar leaders (11/19).

Independent: Durban medical researcher named UNAIDS Special Ambassador (Pillay, 11/20).

New York Times: Bird Flu Is Spreading in Asia, Experts (Quietly) Warn (McNeil, 11/17).

STAT: A plan to develop a Zika vaccine runs into controversy, as questions swirl about price and conflicts of interest (Silverman, 11/17).
STAT: Merck will miss long-promised target for filing Ebola vaccine license with FDA (Branswell, 11/17).

U.N. News Centre: U.N. agencies rush in medical supplies for thousands wounded in Iran-Iraq earthquake (11/17).

U.N. News Centre: In major new report, U.N. environment chief urges ambitious action to save planet from ‘pollution menace’ (11/17).

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Editorials and Opinions

Trump Administration Should Extend TPS For Haitians

New York Times: Let the Haitians Stay
Editorial Board

“…On Thanksgiving, … the Department of Homeland Security is to announce whether it will extend the [temporary protected status (TPS)] that was granted to about 50,000 Haitians when their country was devastated by an earthquake in 2010. … By any reasonable measure, Haiti is not ready to take them back. The destitute country has never fully recovered from the 2010 earthquake or the cholera epidemic that followed. Last year, Hurricane Matthew added even more suffering. The country does not have the resources to absorb 50,000 people, and the money they have sent back is a critical source of income for their relatives and homeland. Every member of Congress who represents South Florida, where most of these Haitians live, is in favor of extending their status. … [T]he only right decision is to extend our welcome to the Haitians” (11/19).

Miami Herald: Marco Rubio: ‘Extend TPS for Haitians in the United States’
Sen. Marco Rubio (R-Fla.)

“Health epidemics and deadly natural disasters in recent years have devastated Haiti and hampered its government’s ability to properly function. … Failure to renew the TPS designation will weaken Haiti’s economy and impede its ability to recover completely and improve its security. … [O]ngoing natural disasters and global health challenges like HIV/AIDS, malaria, and unchecked cholera have undermined Haiti’s ability to meet its full potential. … I continue to strongly support U.S. initiatives that promote good governance and security, combat poverty and health epidemics, and advance economic opportunities for the people of Haiti. I earnestly hope the administration will account for these concerns when they make a determination on whether to extend TPS for Haitians. Its decision will have an immediate and serious impact on individuals, families, and communities in Florida, and a consequential and enduring impact on our friends in Haiti” (11/17).

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Rex Tillerson's Business Experience Not 'Easily Transferable' To State Department Leadership

New York Times: The Trump Administration Is Making War on Diplomacy
Editorial Board

“…Rex Tillerson is widely seen as ill suited to diplomatic leadership and determined to dismantle his own department, which has been central to America’s national security since Thomas Jefferson ran the place. The [State Department] is being undermined by budget cuts, a failure to fill top jobs, an erratic president, and a secretary who has called reorganization, rather than policy, his most important priority. Given the aggressive behavior of North Korea, Russia, and China in a world that seems shakier by the day, the timing could hardly be worse. … All in all, Mr. Tillerson is disrupting the smooth development of career State Department leaders from entry level to the senior ranks, which will create shortages of experienced diplomats down the road. Not surprisingly, morale has plummeted. … Mr. Tillerson is no doubt correct that the State Department, like any bureaucracy, could benefit from scrutiny and thoughtful reform. … But over all, Mr. Tillerson has shown that business experience isn’t easily transferable to government, where the driver is not the bottom line but the national interest…” (11/18).

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Trump Administration Should 'Explicitly Back' U.N. Investigation Of Myanmar's Treatment Of Rohingya

Washington Post: Tillerson is right to call for justice for the Rohingya. He’s naive to think Burma will deliver.
Editorial Board

“Secretary of State Rex Tillerson too often has shown a disregard for human rights issues, especially in his public diplomacy. So his news conference in Burma on Wednesday was a welcome departure. … Mr. Tillerson is understandably seeking to preserve the U.S. relationship with Aung San Suu Kyi [by saying the independent investigation he called for should be led by ‘Myanmar’s civilian government.’] … The alternative could be a regime that would reverse the democratic opening and ally itself with China. But critics’ skepticism is well founded: It is highly doubtful that Aung San Suu Kyi’s government will or can carry out the credible investigation the United States, along with much of the rest of the world, asks for. In the absence of prompt action to create conditions for the voluntary return of the Rohingya and for steps to identify and hold accountable those responsible for atrocities, the Trump administration should proceed with sanctions against senior military leaders, support an international embargo on arms sales, and explicitly back the U.N. investigation” (11/17).

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U.S. Should 'Redouble Its Commitment' To Addressing Global Hunger, Malnutrition

Devex: Opinion: As the global child hunger crisis worsens, the world must act
Tony P. Hall, executive director emeritus of the Alliance to End Hunger

“…[N]ow for the first time in decades, global hunger is on the rise, with an estimated 815 million people now suffering from chronic undernourishment. … This unfolding catastrophe may seem daunting, but cost-effective nutrition interventions, particularly those focused on the critical 1,000-day window between pregnancy and age two, are high-impact and are already saving lives where they are found. … Although we know how to fight this issue, action requires investment. … [T]he United States can and should do more. … Diplomatic leadership at every level, starting with the U.S. secretary of state, is critical to addressing the drivers of conflict, food insecurity, and hunger, and ensuring the strong partnerships with global counterparts that are necessary to achieve lasting results. … Now is the time for the United States to redouble its commitment to the fight against hunger and malnutrition through increased investment and decisive leadership…” (11/17).

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Trump Administration's Development Strategy In Africa Places U.S. Companies First

Global Times: Shift in U.S. aid to Africa signals emphasis on politics
Song Wei, associate research fellow at the Chinese Academy of International Trade and Economic Cooperation

“The U.S. House of Representatives held a hearing on appropriations for U.S. aid to Africa in October. … The hearing reflected the focus and direction of Trump’s African policy, as well as the discrepancy between the U.S. Congress and its Department of State, which exposed the political logic and moral risk of the U.S. foreign aid management structure. … Trump’s ‘American First’ ideology has placed Africa at the bottom of U.S. strategy. The budget reflected its policy. … With geopolitical thinking, the U.S. focuses more on its business interests in Africa. As a result, the Trump administration is trying to leverage more private investment through public-private partnerships, generating economic opportunities for U.S. companies. But development assistance is meant to provide public goods that support the development of recipient countries. This means large investments and long payback periods. Whether this is compatible with business motives is still unclear” (11/19).

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WHO Ministerial Conference Provided Opportunity For Global TB Community To Accelerate Progress Against Disease

The Lancet Global Health: Tuberculosis makes it onto the international political agenda for health … finally
Mario Raviglione, director of the Global TB Programme at the WHO, and colleagues

“…The latest global burden of disease assessment measuring progress on health-related [Sustainable Development Goals (SDGs)] concludes that tuberculosis is one of the health challenges for which dramatic acceleration of progress is most needed. … Within the health-related SDG3 targets, universal health coverage and controlling the epidemics of HIV, diabetes, alcohol-use disorders, and tobacco smoking need to be addressed. The drivers and determinants of the tuberculosis epidemic and the direct risk factors for tuberculosis will, however, need action on other, non-health-related SDGs. These include addressing poverty and social protection (SDG1), hunger (SDG2), indoor air pollution (SDG7), working and living conditions (SDG8), inequalities (SDG10), and urban slums (SDG11). … The WHO Ministerial Conference in November, 2017, should provide ministers of health and their heads of state with essential building blocks towards achieving revolutionary commitments in 2018, and beyond” (11/15).

Thomson Reuters Foundation: To protect against antimicrobial resistance, focus on saving lives from tuberculosis
Jaak Peeters, head of global public health at Johnson & Johnson

“…We have an opportunity to accelerate progress … when the global community meets in Moscow to focus on tuberculosis (TB) … If we can take a holistic approach in turning the tide on TB, we can begin to turn the tide on antimicrobial resistance [AMR] overall. … We desperately need a new operating model, based on shared goals, responsibility, and accountability, to solve the burden of [drug-resistant TB (DR-TB)] and the broader AMR challenge. It will take a sustainable ecosystem built around appropriate financing, incentives, stewardship, and in-country transparency and performance management to support the rapid acceleration of progress against DR-TB and AMR. … I’m convinced that if we all band together and do our part to stop TB, we can do the same to protect the world’s supply of life-saving antibiotics” (11/17).

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Opinion Pieces Discuss World Toilet Day, Importance Of Sanitation As Development Goal

HuffPost: The toilet economy
Carl Manlan, economist, chief operating officer at the Ecobank Foundation, and a 2016 New Voices Fellow at the Aspen Institute

“…[W]e need to integrate and find solutions to increasing awareness and toilet usage, decreasing cost through innovative financing and addressing poor levels of service of public utilities, and resolving issues about logistics and transport. Most specifically, there is a need to integrate mobile money expansion to channel resources to support cashless transactions to pay for toilet usage, latrine emptying, and possible innovative public private purpose schemes. Ultimately, if we want to drive transformation through [the Sustainable Development Goals (SDGs)], we need to make sanitation an added benefit of financial inclusion to generate interest, resources, and solve the public health problems that are eroding gains made under the Millennium Development Goals” (11/17).

HuffPost: On World Toilet Day, Human Waste Makes a Comeback
Chris W. Williams, executive director of the Water Supply and Sanitation Collaborative Council

“…[O]ur urban and rural sanitation and wastewater services, especially in developing countries, are not effectively preventing human contact with excreta — our poo — along the entire sanitation chain. This puts the health of all people — but especially young children — at risk for diseases such as diarrhea … [as well as] cholera, dysentery, hepatitis A, and typhoid. … This World Toilet Day looked beyond achieving sanitation for all as an end but at making access to safe and improved sanitation and hygiene sustainable for all. … On World Toilet Day, we’re reminded that our planet needs practical and alternative solutions to provide safe sanitation for all. It is our collective responsibility to make this a development priority” (11/17).

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From the Global Health Policy Community

CGD, MFAN Examine Considerations For U.S. For Transitioning Countries From Aid Recipients To Partners

Center for Global Development: U.S. Aid for Domestic Revenue Mobilization: What, Where, and How Much
Jared Kalow, former research associate, and Sarah Rose, policy fellow, both at the Center for Global Development, discuss domestic revenue mobilization (DRM), a priority area for USAID that “aims to help partner countries better self-finance their own development priorities [and] is a promising tool for helping select middle-income countries transition away from USAID’s grant-based assistance.” The authors highlight considerations for the U.S. as it “seeks to refine and possibly ramp up its approach to DRM” (11/17).

Modernizing Foreign Assistance Network: MFAN Releases Principles to Guide Country Transitions from Aid to Partnership
“MFAN has published seven guiding principles for strategically transitioning partner countries from development aid to new forms of cooperation with the United States. These principles are meant to inform ongoing reform efforts within the administration and in Congress to ensure that all U.S. development efforts are working toward the goal of creating the conditions under which foreign assistance is no longer necessary…” (11/17).

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Blog Post Highlights Key Takeaways From Global Fund Board Meeting

Friends of the Global Fight: Key Takeaways: The Global Fund’s 38th Board Meeting
This blog post highlights several key takeaways from the Global Fund’s 38th Board meeting held last week, including the selection of Peter Sands as the new executive director; criteria and conditions for countries to receive Global Fund grants; progress on accountability, budget, and strategic priorities; and practices to improve the Board’s role and multi-stakeholder governance (11/17).

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FT Health Discusses Reaching The Last Mile Fund, Features Interviews With New Global Fund ED, Head Of European Medicines Agency

FT Health: Gulf steps up on neglected diseases
The latest issue of the Financial Times’ weekly global health newsletter discusses the newly launched $100 million Reaching the Last Mile fund, aimed at eliminating river blindness and lymphatic filariasis in Africa and the Middle East. The newsletter also includes two short interviews with Peter Sands, the former banker named last week as head of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Guido Rasi, executive director of the European Medicines Agency, who discusses this week’s decision on the agency’s new location outside the U.K. after Brexit. FT Health also features a roundup of other global health-related news stories, journal articles, and releases (Jack, 11/17).

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From the U.S. Government

Global Efforts To Prevent Rubella, Related Congenital Syndrome Making Progress Worldwide

CDC’s “Our Global Voices”: Rubella and CRS Elimination: A Race Worth Winning
Susan Reef, medical epidemiologist and Rubella Team lead, and Gavin Grant, medical epidemiologist, both with the CDC’s Global Immunization Division, discuss global efforts to prevent rubella and congenital rubella syndrome (CRS), including improved vaccination coverage and surveillance. The authors write, “The increase in countries introducing rubella-containing vaccines into their national immunization schedule and the achievement of rubella elimination in the Region of the Americas proves that we are making progress. Now it is time to cross the finish line to win the race in eliminating CRS around the world” (11/17).

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